private medicine

[Reclus]

i have recently changed surgery and been told by the gp that they will not be prescribing prednisolone on a repeat prescription. i have approximately one months supply and am wondering what to do. i don't mind going online and getting it privately does anyone have advice or a source where i can buy this medication. thanks

[PMRpro Ambassador]

Who told you this? Was it a GP who understands PMR?

Complain - as a long term corticosteroid patient you cannot and MUST not stop it suddenly and it is up to them to keep you safe. If they want to insist on seeing you every month, then they must make sure that you have the appointment and the prescriptions available.

You can't buy it online without a prescription and anyway, that isn't the point of the exercise. Speak to the pharmacist who may speak to the GP for you. Then speak to the Practice Manager and explain the situation. If they can't come up with a suitable solution, you need an emergency referral to a rheumatologist.

Have you moved house? Is that why you have changed practice? Is there another practice you could "interview? and see if they know more about PMR?

[Excelsior80]

Will they not prescribe it at all, or do they want to keep prescribing set amounts rather than leave it to you? My GP doesnt do a repeat prescription but sends a new prescription every time the dose changes, for exactly what I need So far its been OK but not very flexible.

[Koalajane]

hi, they can’t not prescribe you pred. So are they saying they wont give it to you at all or that they will not do it on a repeat prescription? If they wont prescribe it at all you need to put in a complaint to the Oractice Manager as you would be in danger of an adrenal crisis.

Good luck sorting this but you must be firm.

[herdysheep]

Ask them exactly what they mean as the interpretation of 'repeat prescription' seems to vary. I have to request my prescription every month rather than it automatically being made available. Another surgery makes the prescriptions out without request to be collected from a pharmacy, etc.

[Supertech]

My Gp has not let me have a repeat prescription in 18months, I either see him or we have a telephone consultation. Last month for the first time he got the surgery pharmacist to call me for an update instead and at the end of the call he mentioned that I could use repeat prescription for December. Yay at last but probably still need to speak to someone in January but at least it’s a start. Although it’s annoying at times I appreciate that he has been keeping a close eye on me.

I am at 6.5mg of pred at present and started on 15mg in May 2023. I have paused tapering for the last couple of months due to mine and my husbands medical problems and will restart again after Christmas.

[CocoaChanel]

I really don’t understand why surgeries are so different throughout the UK! I can see that I am incredibly lucky with mine (south coast, Hampshire)

I have an NHS app. Everything is on there, test results, appointments details and all my prescriptions. When I want to reorder anything I can just tick the box, wait for it to issued and collect from my designated pharmacy. If they can do it why not everywhere? 🤔

If I want to change anything it can still be difficult to get face to face but I write a letter, hand it in to reception and that gets dealt with next day.

[Excelsior80 in reply to CocoaChanel]

I have similar, but the things i can request myself on the app and automatically get dont include pred, i think because its a changing dose and they want to keep checking. If anything goes wrong with the planned taper I will argue for more control but its been ok so far.

[piglette in reply to CocoaChanel]

Remember GP surgeries are all separate entities, the GPs are not part of the NHS. They are all their own little fiefdoms so are run the way the partners want it run. You would expect them all to have different rules.

[Tescohednesford]

Hi, yes my surgery the same...well with prescription.Not in seeing a Dr! but luckily this forum is so useful you can get most of your worries and queries answered..

[NellOHE3]

I am not allowed a ‘repeat prescription’ because the GP needs to monitor my condition. I have to ask for my next prescription and I get a text message asking how I am managing on the current dose etc and a recommendation for tapering. Then the prescription is sent to the pharmacy.

[Motida]

That is a real stress for you. My GP gives me what I ask for on the electronic request system, and I have one or two boxes of 1mg to spare. I am on my last day of 10 mg from a flare and will be dropping to 7 or 6.5mg - fingers crossed.

Let me know your address and I will put them in the post to you if you are really stuck. Good luck with your negotiations. If all fails a quick appt with Dr Hughes in Chertsey might be the answer for the moment.

[Mandyq]

I had a similar situation with regard to “repeat” prescriptions.

The practice suggested I should submit a written request each month. I discussed with GP and she explained the reason was that she would like to see a taper rather than me remaining on the same dosage long term.

We agreed a general plan for a v slow reduction and she’s been happy to go with this. I now have 5mg, 1mg and 0.5mg appearing on the NHS prescription page and I just pick the selection I need. I found it works well. Having said that I did need to be quite assertive when proposing my very slow taper - in the end I think she just caved in to get me out of the surgery 🤣

[Estellemac]

My GP changed and I have to call monthly for the prescription as they took me off the repeat I'd had for 7 years. They did it for my benefit to ensure I was on the right dose for tapering and issue a monthly dose on request. Just got to make sure you order in plenty of time and the GP will probably want a call with you to check how you are doing? Same as reply as Excelsior80 really?

[Nextoneplease]

Well, I used to feel blessed that I can request pred and it is generally approved in the nhs app without question. However after nearly four years of this, I am realising that in my case at least, the concomitant factor is that my condition is never reviewed unless I raise a specific issue.

It works both ways. That said, obviously I hope you get a regular prescription (and reviews). You can do without the stress and uncertainty of constant requests! Good luck x

[PMRnewbie2017]

Are you under the care of a Consultant? Could you contact the Rheumatology department at the hospital and explain? The treatment of PMR aside, "they" need to understand that after 6 years on Pred you have HPA axis suppression and cannot under any circumstances be without Pred. The trouble is with Christmas looming, surgeries and pharmacies are operating on shorter hours with Bank holiday closures, so you really need to get onto this asap.

Because we're talking Pred here, a practice nurse or clinical pharmacist is unlikely to have the authority to sort this out for you. It will have to be a Dr.

[Bcol]

I would hope/assume that this means you will need to discuss with them through a monthly appointment/telephone call what you/they think your next requirement will be. Not a problem I had but you could argue that if it means you have a sensible conversation with the medical staff then they are keeping up to date with how things are going. All very fiddly though when appointments at many surgeries are hard to come by. To refuse you Pred at all would put you at serious risk and put them open to a charge of professional negligence.

[piglette]

As I understand it, GPs can issue 60 days of medication. They then want people to come back to them so they can see how that person is doing and prescribe another 60 days. Otherwise people just get put on the back burner with possibly too many drugs issued while this system ensures people have regular doctors’ support.

[DorsetLady PMRGCAuk volunteer in reply to piglette]

As you say. In some instances, too many drugs for some - and some which shouldn’t be mixed. Can add to confusion -for patients and prescribers..

[PMRpro Ambassador in reply to DorsetLady]

But they do need to make sure patients don't end up without medication that can't be just stopped and started!!!